多层螺旋CT对胰腺囊腺瘤与囊腺癌的诊断价值  

Diagnostic value of multi-slice CT in pancreatic cystadenoma and cystadenocarcinoma

作　　者：罗帝林[1] 赵志清[1] 黄春元[1] 张建文[1] 叶定开[1] 陈利庆 彭华荣[1] 莫金潮[1] 

机构地区：[1]广州医科大学附属深圳沙井医院放射科,广东518104

出　　处：《放射学实践》2014年第4期419-422,共4页Radiologic Practice

摘　　要：目的:探讨胰腺囊腺瘤和囊腺癌的多层螺旋CT表现及其诊断价值。方法:回顾性分析21例经手术病理证实的胰腺囊腺瘤和囊腺癌的多层螺旋CT表现。所有患者均行CT平扫及增强扫描,并采用多平面重组(MPR)和最大密度投影(MIP)等方法对图像进行后处理。结果:21例中胰腺浆液性囊腺瘤7例,其特征性的CT表现有蜂窝样囊性病灶(6例)且单个小囊最大直径≤2cm、分叶状(4例)、囊壁及囊内间隔增强后呈轻度强化(7例)、囊壁光整(7例)。黏液性囊腺瘤4例,主要CT表现为多房囊性病灶(4/4)、绝大多数小囊的最大直径>2cm、囊壁较厚且厚薄不均(4例)、2例可见壁结节,增强扫描示囊壁、分隔及壁结节有轻度-中度强化。胰腺囊腺癌10例,CT平扫示肿瘤呈囊状低密度影,有壁结节及分隔;增强扫描示囊壁、壁结节及分隔呈中度-明显强化。结论:胰腺黏液性和浆液性囊腺瘤及囊腺癌的MSCT表现有一定特征性,MSCT对本病的诊断及鉴别诊断具有重要的临床价值。Objective：To investigate the MSCT features of pancreatic cystadenoma and cystadenocarcinoma and their diagnostic value. Methods;The CT manifestations of 21 patients with pancreatic cystadenoma and cystadenocarcinoma confirmed by surgery and pathology were analyzed retrospectively. All the patients underwent plain and contrast enhanced CT scan, with MPR and MIP technique for image postprocess. Resuits：Of 21 cases, 7 cases （7/21） were pancreatic serous cystadenomas,with charactristic manifestations including honeycomb appearance with multiple small cysts smaller than 2ram （n=6） ,lobulated contour （n=4）,and mild enhancement of the smoothing wall and septa. There were 4 cases of pancreatic mucous cystadenomas,which were multilocular cystic like a honeycomb, with thick and irregular wall （n= 4） and mural nodules （n= 2） ;after administration of contrast agent, the septa and mural nodules showed mild to moderate enhancement. There were 10 cases of pancreatic cystadenocarcinomas;single cystic low density lesions with wall nodules and septa were showed on plain CT;the wall,septa and mural nodules showed moderate to severe enhancement on post-contrast CT. Conclusion;There are some characteristics in CT manifestations of pancreatic cystadenomas and cystadenocarcinomas. MSCT is helpful for the diagnosis and differential diagnosis of pancreatic cystadenoma and cystadenocarcinoma.

关 键 词：胰腺肿瘤 囊腺瘤 囊腺癌 体层摄影术 X线计算机 诊断 

分 类 号：R730.44[医药卫生—肿瘤] R735.9[医药卫生—临床医学]